Huh Min Gu, Jeong Yoon, Shin Young In, Kim Young Kook, Jeoung Jin Wook, Park Ki Ho
Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea; Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea; Department of Ophthalmology, Yeungnam University Hospital, Daegu, Korea.
Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea; Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
Ophthalmology. 2025 Jan;132(1):39-51. doi: 10.1016/j.ophtha.2024.07.013. Epub 2024 Jul 15.
To investigate whether a difference exists in intereye glaucoma severity and progression in patients with asymmetric axial length.
Long-term observational study.
Patients older than 20 years with a diagnosis of glaucoma at Seoul National University Hospital, Seoul, Korea, between 2010 and 2020.
Patients with a diagnosis of glaucoma in both eyes with an axial length difference of more than 1.0 mm were included. Each individual's eyes were classified into longer eye and shorter eye, and the baseline and follow-up clinical data were analyzed using the paired T-test and McNemar test.
Differences in clinical characteristics in patients with asymmetric axial length.
A total of 190 eyes of 95 patients with glaucoma with asymmetric axial length were included in the study. The patients' mean age was 51.2 ± 12.3 years, and the mean follow-up period was 10.1 ± 3.9 years. No difference was found in baseline intraocular pressure (IOP) or central corneal thickness between longer eyes and shorter eyes. Among the baseline disc parameters, ovality index, β-zone and γ-zone parapapillary atrophy (PPA) area were larger (P < 0.001) in the longer eyes. In the baseline OCT data, the retinal nerve fiber layer (RNFL) thickness (P = 0.009) and ganglion cell-inner plexiform layer (GCIPL) thickness (P < 0.001) were thinner in the longer eyes. According to a baseline visual field (VF) test, the mean deviation and VF index (VFI) values were significantly lower (P < 0.001, P = 0.034) in the longer eyes. Based on an analysis of glaucoma progression, the rate of change of superior GCIPL (longer eyes, -0.65 μm/year; shorter eyes, -0.40 μm/year), mean deviation (longer eyes, -0.40 dB/year; shorter eyes, -0.21 dB/year), and VFI (longer eyes, -0.92%/year; shorter eyes, -0.46%/year) were larger (P = 0.006, P = 0.005, P < 0.001) in the longer eyes. Additionally, the greater the difference in IOP fluctuation, the greater the difference in the rate of change between mean deviation and VFI.
When an axial length difference of more than 1.0 mm was present, glaucoma tended to be more severe and to progress faster in the longer eyes.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
探讨眼轴长度不对称的患者双眼青光眼严重程度及进展是否存在差异。
长期观察性研究。
2010年至2020年期间，韩国首尔国立大学医院诊断为青光眼的20岁以上患者。
纳入双眼诊断为青光眼且眼轴长度差异超过1.0mm的患者。将每个个体的眼睛分为较长眼和较短眼，并使用配对t检验和McNemar检验分析基线和随访临床数据。
眼轴长度不对称患者的临床特征差异。
本研究共纳入95例眼轴长度不对称的青光眼患者的190只眼睛。患者的平均年龄为51.2±12.3岁，平均随访时间为10.1±3.9年。较长眼和较短眼之间的基线眼压（IOP）或中央角膜厚度无差异。在基线视盘参数中，较长眼的椭圆率指数、β区和γ区视盘旁萎缩（PPA）面积更大（P<0.001）。在基线光学相干断层扫描（OCT）数据中，较长眼的视网膜神经纤维层（RNFL）厚度（P=0.009）和神经节细胞-内丛状层（GCIPL）厚度（P<0.001）更薄。根据基线视野（VF）检查，较长眼的平均偏差和VF指数（VFI）值显著更低（P<0.001，P=0.034）。基于青光眼进展分析，较长眼中上GCIPL的变化率（较长眼，-0.65μm/年；较短眼，-0.40μm/年）、平均偏差（较长眼，-0.40dB/年；较短眼，-0.21dB/年）和VFI（较长眼，-0.92%/年；较短眼，-0.46%/年）更大（P=0.006，P=0.005，P<0.001）。此外，眼压波动差异越大，平均偏差和VFI变化率的差异就越大。
当眼轴长度差异超过1.0mm时，较长眼中青光眼往往更严重且进展更快。
作者对本文讨论的任何材料均无所有权或商业利益。
